Usage of Low-dose Glimepiride (0.5 mg) and Metformin Combination in the Management of Type 2 Diabetes Continuum in Indian Setting

Background: To understand the approach of clinicians about the treatment pattern, dosage, efficacy and safety of the combination of low-dose glimepiride (0.5 mg) and metformin fixed-dose combination (FDC) in the management of type 2 diabetes mellitus (T2DM) continuum in Indian settings. Methods: This case-based questionnaire survey included health care professionals (n = 112) across India, who were prescribing glimepiride and metformin FDC. Data were collected from the medical records and analyzed. Results: The data of 1,403 patients with T2DM were included. The mean age was 49.1 years and 68.4% of patients were males. The median duration of T2DM was 36 months. A total of 86.7% of patients received glimepiride and metformin FDC as first-line therapy. The most commonly prescribed (71.5%) dosage of glimepiride and metformin was 0.5 mg/500 mg. The titration of the dose was performed in 231 patients, of which 82.7% required up-titration and 17.3% required down-titration. The mean glycated hemoglobin (HbA1c), fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels reduced significantly (mean change: 1.2%, 36.5 mg/dL and 50.2 mg/dL,respectively) post-treatment. The hypoglycemic event and weight gain were reported in 7.7% and 9.5% of patients, respectively. Overall physician’s global evaluation of efficacy and tolerability was rated good to excellent in the majority of patients (>85%). Conclusion: Results demonstrate low-dose (0.5 mg) glimepiride and metformin FDC is effective in achieving glycemic control through lowering HbA1c, FPG and PPG levels with acceptable safety outcomes

Usage Pattern of Glimepiride/Metformin Fixed-dose Combination in Type 2 Diabetes Patients with CVD or at Risk of CVD: An Experience in Indian Setting

Background: Diabetes is associated with almost twofold increased risk of cardiovascular diseases (CVD). The present case-based questionnaire survey evaluated the treatment pattern and clinical experience of healthcare professionals in prescribing glimepiride/metformin fixed-dose combination (FDC) to type 2 diabetes mellitus (T2DM) patients with CVD or those patients who are at risk of CVD in the Indian settings. Material and methods: A retrospective, multicenter, observational, case-based questionnaire survey was conducted in Indian healthcare centers using medical records of patients having T2DM, with CVD or are at risk of CVD, who were prescribed any strength of glimepiride/metformin FDC. Data was collected from the patients’ medical records and was analyzed using statistical tests. Results: A total of 680 patients with T2DM with CVD or at risk of CVD were included in this study. Mean duration of diabetes in the patients was 5.7 ± 4.8 years. About 68.5% patients had hypertension, 47.9% had dyslipidemia, 25.4% had coronary artery disease (CAD), 3.6% had transient ischemic attack (TIA), 4.8% had peripheral arterial disease (PAD) and 2.9% had heart failure. Around 18.1% patients had CVD after diabetes was diagnosed, while 81.9% presented with cardiovascular (CV) issues at the time of diabetes diagnosis. All patients received glimepiride/metformin FDC as first-line therapy. About 68.2% patients on glimepiride/metformin FDC had blood pressure within optimal limits. A large proportion of patients had improvement in glycemic parameters. Weight change was noted in 18.4% of the patients overall. Of these, 59.2% had reduction in weight. There were no major adverse events and treatment efficacy and tolerability were reported as good to excellent for 94.6% and 92.9% patients, respectively. Conclusion: This case-based questionnaire survey demonstrates the usage pattern of various strengths of glimepiride/metformin FDC and the clinicians’ practice approach regarding early initiation of this combination in Indian patients with diabetes who have or are at risk of CVD